Anxiety disorders are conditions that are characterized by pathological anxiety that has not been caused by physical illness and is not associated with substance use besides not being part of a psychotic illness (Starcevic, 2004, p. 1). The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), anxiety disorders comprise of a group of diagnostic entities. They include panic disorder (with or without agoraphobia), agoraphobia without history of panic disorder, acute stress disorder, specific phobia, obsessive-compulsive disorder, social anxiety (social phobia), posttraumatic stress disorder, anxiety disorder due to a general medical condition, substance-induced anxiety disorder, general anxiety disorder and anxiety disorder not otherwise stated (ibid). This paper explores the different types of anxiety disorders.
Many people have suffered from panic disorder. The central characteristic of panic disorder is that of having distinct episodes of intense anxiety. These episodes develop abruptly and seemingly lack of adequate precipitating factor. They tend to reach maximum intensity over a period of a few minutes and last for an unpredictable period of time. Those who have had panic attacks report that they have never had any experience quite so terrifying. However, they frequently seem at a loss as to how to express the exact emotional ingredients. It is apparently difficult for someone who has never had such an attack to understand the impact. Another characteristic of panic disorder is a persistent worry that a panic attack may occur. This unpredictability typically causes additional consternation to those affected. Some people may worry excessively about their health since they feel that something is ‘really wrong’ or they may be preoccupied with modifying their behavior in an effort to guarantee that a panic attack will not happen.
DSM-IV describes general anxiety disorder as involving ‘excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities” (McLean, 2001, p. 260). The worry associated with this type of anxiety is difficult to control and is accompanied by three or more somatic symptoms. The symptoms are being easily fatigued, irritability, muscle tension, sleep disturbance, restlessness and having difficult in concentrating. The diagnosis of requires that the symptoms cause clinically significant distress of functional impairment. However, the impairment caused by the general anxiety disorder is often mild in comparison with other anxiety disorders (Antony et al., 2001, p. 95). Although the symptoms between generalized anxiety and depression overlap, general anxiety disorder (GAD) is chronic rather than episodic. Research has shown that in a normal population, there is an annual prevalence rate of 3.1% and a lifetime prevalence rate of 5.1% for general anxiety disorder (Grandison et al., 2007, p. 51). It shows that GAD was found to be the most prevalent (2.9%) of all anxiety disorders. Women are highly vulnerable to GAD as compared with their male counterparts.
Social anxiety/social phobia refers to the fear of negative evaluation. Persons with social phobia have a strong fear of a variety of situations especially in any given social setting. This involves all situations in which they are open to possible scrutiny from other people. The basic fear in these situations is the fear of being embarrassed or rather humiliated. In social situations requiring interaction with others, the phobic person is often afraid of being unable to begin a conversation or that the discussion will quickly sputter to a halt, leaving a mortifying silence for which he/she will feel responsible (Grandison, et al. 2007, p. 66). In most cases, the person with social phobia feels unable to make small talk and worries about how to behave; what to do with their hands, how to sit or stand and what sort of facial expression to adopt among other aspects. Additionally, social phobics usually fear situations that do not inherently involve interaction but nevertheless include the possibility of scrutiny from other (Starcevic, 2004, p. 46). Some of the performance situations are dramatic or musical performances, eating or drinking in public, using public washrooms or even writing in public. The detrimental effects of social phobia include having less education, having lower incomes and having less access to social support. Persons with social phobia often avoid a wide range of social situations.
Posttraumatic stress disorder (PTSD) is another type of stress disorder. The hallmark of traumatic experiences is their ability to engender such reactions as shock, horror, disbelief, helplessness, and anxiety. Simply being exposed to horrific events does not automatically trigger PTSD ((McLean, 2001, p. 101; Antony et al., 2001, p. 76). The focus is necessarily on the reactions to traumatic events rather than on the events themselves. Immediately following a traumatic event, survivors commonly experience an acute stress response (Antony et al., 2001, p. 88). The intensity of this reaction will depend on several factors, including the severity and persistence of the traumatic event, the extent of exposure and the meaning of personal significance the event holds for the individual. The natural course of reaction to trauma is for the individual to adapt and for the stress response to resolve with time. For some victims, the symptoms for this type of anxiety disorder are chronic. The most common sources of PTSD in the developed countries are rape, assault and accidents while in the third world, the common causes are war and natural disasters. A common aspect of traumatic events to the victims is intense fear deriving from ones helplessness to prevent real or threatened physical injury or death, along with a shattering of one’s expectations about how life should be.
Obsessive-compulsive disorder (OCD) is arguably the most intriguing and challenging of all of the anxiety disorders. Its defining characteristics involve unwanted and abhorrent mental content, such as thought or ideas, which are uncontrolled and often followed by either mental or behavioral rituals that function to ease the anxiety provoked by the obsessions. Most of the victims of OCD engage in overt rituals or compulsions that logically relate to their worries. According to McClean, “washers clean to rid themselves of contaminants; hoarders save things because one day the items may be critically important to them” (2001, p. 107). Those who have obsessions that have little or no behavioral compulsions often get governed by complex rules having no apparent connection with the obsessions that precede them. Unlike the other anxiety disorders, people suffering from OCD are more often ashamed of their symptoms, which may be less visible and hard for close friends as well as family to understand. Consequently, OCD can be shrouded in secrecy, hidden in people who outwardly seem entirely normal (Antony et al., 2001, p. 102). Severe levels of OCD often result in such functional impairment that sufferers receive disability compensation.
Experiment
The type and level of anxiety (either social phobia or GAD) expressed by a child is dependent on the model of decision-making applied by the parents.
Hypothesis 1. Children raised by parents who are not co-operative and friendly towards each other experience one of the fears.
Hypothesis 2: Children raised by parents who are co-operative and friendly towards each do not have any anxiety disorder.
The sample will be of middle-school students in a public school.
The experiment will involve two types of questionnaires. One of the questionnaires will have questions that will enable the examiner to determine the type of anxiety an individual has. This will incorporate characteristics described under the GAD and social phobia (the two types of anxiety disorders being examined). The other questionnaire will be based on the different models of decision-making applied in most families. It is important to mention that the family models used for this part will not related to factors such as family’s size and socio-economic status among others. The models will be as follows:
1. One parent is seen as the head of the family, makes the final decisions. Only the other parent has the right to give suggestions but he/she can only expect her advice to be taken into account.
2. Identical to 1 above but the ‘head’ only makes the final decision on the most important issues. In the less important issues, each of the parents applies his/her expertise and competence in deciding what to be done.
3. Only one of the parents has total control over the decisions made and always has the final word. The other (as well as children) are never consulted.
4. Both parents discuss a problem together and reach an agreement on a solution before announcing their decision to the family.
5. As 4 above, only that ‘decision’ is a rather too strong term for the parents’ manner of solving problems. They talk over them i.e. the problems; around them until a form/sort of a common view emerges which then becomes the basis of action.
6. The parents consult each other and agree about what the family should do. However, each parent still has the right to act on his/her own in making decisions in the family. If the other parent wishes, he/she can review the decision and give his/her view before arriving at the final decision.
7. As 8 above but should the two parties not agree especially on urgent matters, one parent can break the tie and deliver the final decision.
9. The family has no standard way of making decisions and parents may or may not consult. If one of the parents does not agree, he/she can intentionally withhold the necessary resources e.g. money or time to prevent the implementation of the reputed decision.
For the second questionnaire, the respondents will be required to use numbers (1-9) to indicate the model(s) that best describes their family in an ascending order.
References
Antony, M. M., et al. (2001). Practitioner’s Guide to Empirically Based Measures of Anxiety.
Hingham, MA: Kluwer Academic Publishers.
Grandison, K., et al. (2007). Understanding School Refusal: A Handbook for Professionals in
Education, Health and Social Care. New York: Jessica Kingsley Publishers.
McClean, P. D. (2001). Anxiety Disorders in Adults: An Evidence-Based Approach to
Psychological treatment. Cary, NC: Oxford University Press.
Starcevic, V. (2004). Anxiety Disorders in Adults: A Clinical Guide. Cary, NC: Oxford
